Neighborhood Makes or Breaks Active Ageing? Findings from Cross-Sectional Path Analysis.

Mental ill-health prolongs and complicates other chronic illnesses, which is a major public health concern because of the potential stress it places on health systems. Prevention via active aging and place-based interventions thus became increasingly important with population aging, e.g., through health promotion and age-friendly neighborhoods. However, how the targeted outcomes of these efforts are related remains unclear. This paper examined whether the relationship between active living and mental health or health-related quality of life is mediated by neighborhood cohesion. Cross-sectional data were drawn from n = 270 community-dwelling adults aged 50 and above in the Gerontology Research Program-Center for Ageing Research in the Environment (GRP-CARE) Survey. Path analysis showed that one can live actively for better mental health (Btotal = 0.24), but it is largely mediated by neighborhood cohesion (37%). Further examination of the factors of neighborhood cohesion showed that this mediation is explained by communal affordance (Bindirect = 0.05) and neighborhood friendship (Bindirect = 0.05). Additional study of the association between these mediators and factors of mental health revealed two psychosocial processes: (1) better community spaces (e.g., greenery and third places) support communal living (B = 0.36) and help older adults obtain emotional support (B = 0.32) for greater autonomy (B = 0.25); (2) spending more time outdoors enhances neighborhood friendship (B = 0.33) and interpersonal skills (B = 0.37), which in turn improves coping (B = 0.39). In short, the effects of active living on health are limited by one's neighborhood environment. Neighborhood cohesion must be considered or it may stifle individual and policy efforts to age actively and healthily in urban environments. Context-sensitive implementations are required.

Association between childhood invalidation and borderline personality symptoms: self-construal and conformity as moderating factors.

BACKGROUND: Linehan (1993)'s biosocial model posits that borderline personality disorder (BPD) symptoms develop as a result of a transactional relationship between pre-existing emotional vulnerability and an invalidating childhood environment. Little work, however, has investigated cultural factors that may influence the relationship between childhood invalidation and BPD symptoms. The present study investigated the association between parental invalidation and BPD symptoms, and the role of conformity and self-construal as potential moderators of this association. METHODS: Two hundred and ninety undergraduate students were recruited from a large university in Singapore and administered questionnaires measuring Asian values, self-construal, parental invalidation, and BPD symptomatology. RESULTS: Multiple regression analysis demonstrated a significant positive association between BPD symptoms and maternal invalidation. Moderation analyses revealed a 3-way interaction, indicating that the maternal invalidation and BPD symptoms association varied by degree of conformity and self-construal. Among participants with interdependent self-construal, maternal invalidation was associated with BPD symptoms only at high conformity levels. No significant moderating effect was found among participants with independent self-construal. CONCLUSIONS: Overall, the study found empirical support for aspects of Linehan's biosocial model in an Asian context, and has implications for developing a culturally-informed understanding of BPD.

Characterisation of Physical Frailty and Associated Physical and Functional Impairments in Mild Cognitive Impairment.

OBJECTIVE: To characterize the physical frailty phenotype and its associated physical and functional impairments in mild cognitive impairment (MCI). METHOD: Participants with MCI (N = 119), normal low cognition (NLC, N = 138), and normal high cognition (NHC, N = 1,681) in the Singapore Longitudinal Ageing Studies (SLAS-2) were compared on the prevalence of physical frailty, low lean body mass, weakness, slow gait, exhaustion and low physical activity, and POMA balance and gait impairment and fall risk. RESULTS: There were significantly higher prevalence of frailty in MCI (18.5%), than in NLC (8.0%) and NHC (3.9%), and pre-frailty in MCI (54.6%), NLC (52.9%) than in NHC (48.0%). Age, sex, and ethnicity-adjusted OR (95% CI) of association with MCI (versus NHC) for frailty were 4.65 (2.40-9.04) and for pre-frailty, 1.67 (1.07-2.61). Similar significantly elevated prevalence and adjusted ORs of association with MCI were observed for frailty-associated physical and functional impairments. Further adjustment for education, marital status, living status, comorbidities, and GDS significantly reduced the OR estimates. However, the OR estimates remained elevated for frailty: 3.86 (1.83-8.17), low body mass: 1.70 (1.08-2.67), slow gait: 1.84 (1.17-2.89), impaired gait: 4.17 (1.98-8.81), and elevated fall risk 3.42 (1.22-9.53). CONCLUSION: Two-thirds of MCI were physically frail or pre-frail, most uniquely due to low lean muscle mass, slow gait speed, or balance and gait impairment. The close associations of frailty and physical and functional impairment with MCI have important implications for improving diagnostic acuity of MCI and targetting interventions among cognitively frail individuals to prevent dementia and disability.